Adult Community-acquired Bacterial Meningitis in Srinagarind Hospital

Abstract

The total 19 cases of community-acquired bacterial meningitis who were admitted in Department of Medicine, Srinagarind Hospital during December 1983 to November 1988 were reviewed.  Age incidence was ranged from 16 years to 69 years, male to female ratio was 5.3:1.  The majority of them were farmer and lived in Khon Kaen and nearby provinces.  There was no seasonal variation.  The common presenting symptoms were headache (94.7%), fever (89.4%), alteration of consciousness (68.4%) and nausea/vomiting (57.8%).  Meningeal signs were found in 84.2%.  Complete blood count showed leukocytosis and shift to the left.  In almost all of them, cerebrospinal fluid revealed white blood cell more than 1,000 cells/cu.mm. with polymorphoneuclear cell predominated, high protein (100-500 mg./dl.) and low sugar profile.  Gram stain and culture of CSF were positive in 78.9% and 68.4% respectively.  The most common organism was Stretococus pneumoniae.  The symptoms improved after treatment within 1-4 days.  The mortality rate was 36.8%.